“User Experience Is Everything”: How Leaders Can Decommission Apps with Minimal Disruption

Any time a health system is migrating to a new system, there are decisions that have to be made with the data — what needs to be accessible, what can be archived, and how should it be done. For Intermountain Healthcare’s case, which embarked on an enormous initiative to replace 40-year-old self-developed systems with an integrated platform (Cerner), the questions seemed endless.

“We had lots of applications, a lot of legacy data, and a lot of challenges,” said Marc Probst, who has held the CIO role at Intermountain since 2003. One of those challenges? Ensuring data is usable and applicable after “hundreds, if not thousands of applications” were retired, without having to continue to pay licensing fees.

Cara Babachicos, now CIO at South Shore Health, faced a similar quandary while she was leading the data archiving project at Partners Healthcare when it began transitioning to Epic. “We were trying to archive cloud-based systems that needed to be decommissioned, because there are pretty high maintenance fees that go along with keeping a system alive when you still need the data for legacy purposes,” she added. “We wanted to archive data in a way that would users access it easily when they needed it.”

During a recent webinar, Probst and Babachicos discussed this timely topic, along with Kamal Patel, CIO at Ellkay. And although several key themes emerged, the most important was to ensure a positive experience for users, and ensure those who care for patients can access the information they need, when they need it.

“User experience is everything,” said Patel, who believes it starts by understanding the needs of various departments within a health system, and ensuring those unique needs are met. During the discussion, the panelists outlined several ways in which healthcare IT leaders can address this critical component.

Below are some best practices for ensuring a positive user experience:

Build trust. “What people are looking for is trust,” said Patel. The way to build that is by ensuring the teams working on data migration projects are educated on the health system itself, as well as the management tiers and the communication preferences.

Understand fear. Oftentimes when a system is being retired, stakeholders become fearful that they’ll lose the data, “or the appearance of the data the way they need it,” noted Babachicos. “We need to work with users to ensure them that what they consider the legal medical record, and what they need to be able to produce, can be produced.” And that entails showing them how they can access the necessary data elements. “You need to establish credibility that you can do what they need. That’s a big part of the user experience.”

Manage at the appropriate level. Leaders also need to recognize that staffers can become threatened any time a third party is brought in, even if it represents a different skillset, according to Probst. “You need to be very careful that you’re managing at the appropriate level.”

Include users in the process. It’s also important to remember that the organization is very dependent upon the knowledge users bring to the table. Therefore, CIOs need to make sure users feel like they’re part of the solution. “We need to engage folks who have used the data, have needed to access data in the past, and will need to access it in the future,” said Probst. “When they’re part of the resolution, they’re more likely to make it successful.”

Minimize training (and make it fit into the workflow). It may seem obvious, but too often, accessing archived data can be an onerous process. By taking steps like building buttons in the EMR that enable contextual linking, leaders can make these systems intuitive and easy to learn, which is a big satisfier. “The key to any solution is to minimize the requirement for training so it fits into the workflow. But there are still times we need to train. It’s just like any other implementation; it’s paying attention to the subject matter experts and the things they need, and making it fit into their workflow so it’s not something they have to look for,” said Probst.

Speak their language. It’s only natural for users to be hesitant when there’s a change — especially with a system that’s been in use for years (or even decades). That’s why Patel’s team makes it a point to go onsite to speak with users in person, and make sure they have individuals who speak the languages of different departments like HIM. “It’s not just, ‘the CIO has signed off, so now we proceed,’” he noted. “There’s a process for getting buy-in with stakeholders. Once you built that trust, it really has a positive impact on the project.”

Have tough conversations upfront. Although it’s critical to obtain feedback from users, leaders must be careful not to fall down the rabbit hole of over-customization, said Babachicos. This can be done by having conversations upfront about what data is being archived, and making sure users understand other ways in which it can be accessed. “Keep it simple,” she said. “Don’t over-engineer it and don’t overthink it.”

Think about the end game. One of the biggest mistakes leaders can make, according to Probst, is not considering the end goals. If that doesn’t happen, “you end up creating a whole bunch of data archives that aren’t well-linked or well-standardized, and you may end up having to do it all over again.”

Finally, the panelists stressed the value of being transparent, especially when it comes to decision-making around data retention. “I don’t think we’ve ever come across a piece of data that we didn’t want to keep forever,” said Probst. “But it costs money, whether you’re doing the work to decommission and archive that data, or you’re maintaining it and using it for future reports, or just trying to keep it synchronized and secured. And so, having the right conversations with our end users is really important.